# UnitedHealth warns it may exit Obamacare plans **URL:** \ **Category:** Great Debates\ **Created:** [November 19, 2015, 8:37pm UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013 "2015-11-19T20:37:59Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [November 20, 2015, 6:41am UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/21 "2015-11-20T06:41:14Z")
Nothing about the VA prevents veterans from paying for private health insurance. Ditto for Medicare. ---
**Author:** ![Claverhouse](https://avatars.discourse-cdn.com/v4/letter/c/13edae/32.png) [@Claverhouse](https://boards.straightdope.com/u/Claverhouse)\ **Post date:** [November 20, 2015, 6:41am UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/22 "2015-11-20T06:41:37Z")
Just as an aside, how many times — rough average — is an American expected to change health insurance over a lifetime [let’s optimistically call that 80 years] ? ---
**Author:** ![Kobal2](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kobal2/32/20_2.png) [@Kobal2](https://boards.straightdope.com/u/Kobal2)\ **Post date:** [November 20, 2015, 7:31am UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/23 "2015-11-20T07:31:24Z")
> [@adaher](#): > > Nothing about the VA prevents veterans from paying for private health insurance. Ditto for Medicare. Nor does single-payer. It’s relatively common in countries that have a government-mandated single-payer HC system for the middle class and up to have both government health insurance and a private one on top, typically covering quality-of-life medical costs the national healthcare system doesn’t (glasses and dental, home care, elective surgeries etc…). ---
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [November 20, 2015, 8:49am UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/24 "2015-11-20T08:49:44Z")
Obamacare was intended to be _ **mandatory** _. If the mandate is not enforced, of course unhealthy people are more likely to get insurance than healthy people. Insurance companies can’t thrive charging normal-health premiums for mostly bad-health patients. I’m surprised it took so long for the problem with not enforcing the mandate to appear. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [November 20, 2015, 8:53am UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/25 "2015-11-20T08:53:21Z")
That was foolish though, because mandatory health insurance is unconstitutional, and a constitutional law professor would at least be aware that such an idea was pushing the envelope and risky. ---
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [November 20, 2015, 9:42am UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/26 "2015-11-20T09:42:09Z")
I thought SCOTUS approved the mandate; which is being deferred for other reasons. No? But it all goes to reinforce how much better single-payer, or at least some public option, would be. Especially infuriating are all the right-wingers – you can find them right here at SDMB – braying that single-payer would be better than ACA. Where were you when it was clear that healthcare reform would be passed and the right-wing could have produced a grand single-payer compromise? ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [November 20, 2015, 9:54am UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/27 "2015-11-20T09:54:11Z")
> [@septimus](#): > > I thought SCOTUS approved the mandate; which is being deferred for other reasons. No? It was approved as a tax, but rejected as a commerce clause power. So Congress can’t make you get health insurance by putting you in jail if you don’t, they can only charge you a tax. > [@](#): > > But it all goes to reinforce how much better single-payer, or at least some public option, would be. Especially infuriating are all the right-wingers – you can find them right here at SDMB – braying that single-payer would be better than ACA. Where were you when it was clear that healthcare reform would be passed and the right-wing could have produced a grand single-payer compromise? There’s too much of a gap between what we want and what the left wants. I’d take a single payer system that paid catastrophic costs only, along with the Medicaid expansion for the poor. Liberals want comprehensive care for all. ---
**Author:** ![GrumpyBunny](https://avatars.discourse-cdn.com/v4/letter/g/bc8723/32.png) [@GrumpyBunny](https://boards.straightdope.com/u/GrumpyBunny)\ **Post date:** [November 20, 2015, 2:01pm UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/28 "2015-11-20T14:01:33Z")
> [@Trinopus](#): > > Why didn’t they bail out of Medicare decades and decades ago? > > This sounds like more anti-Obamacare hogwash from Fox News, rather than any kind of meaningful economic commentary. Which is what I said in a Facebook argument. UHC’s profits in Q1 [sound](http://www.modernhealthcare.com/article/20150416/NEWS/304169977)pretty good: > [@](#): > > Profit jumped almost 29% year over year in the first quarter, totaling more than $1.4 billion. UnitedHealth’s revenue increased 13% to $35.8 billion. Maybe they expanded too quickly? > [@](#): > > UnitedHealthcare, the company’s insurance subsidiary, expanded its presence on the Affordable Care Act’s insurance exchanges this year from four to 23 states. Executives said there was a “positive market response” to the company’s individual public-exchange products. ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [November 20, 2015, 2:07pm UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/29 "2015-11-20T14:07:24Z")
> [@Bone](#): > > I love it. _‘You wonder how we make a profit if we lose money on every transaction. Simple, volume!’_ - [First Citywide Change Bank](https://screen.yahoo.com/first-citywide-change-bank-2-000000534.html?query=First%20citywide%20change%20bank) (SNL) That’s not as silly as may seem. The idea is that the sickest people would be the first to run out and buy insurance, but that if the market expanded to healthier people it would become more profitable. > [@adaher](#): > > As for United Health, everyone knows I’m very pessimistic about ACA, but I don’t see this as particularly dangerous news. The exchange business model will work for some insurers, for others it won’t. An insurer has to recognize what kind of pool they are insuring and set rates appropriately. United Health was one of the companies that was probably setting rates too low. I’m not sure if you read the OP, but it quoted an analyst who said the exact opposite. (See the third quotebox.) ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [November 20, 2015, 2:41pm UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/30 "2015-11-20T14:41:46Z")
A lot of ACA boosters in this thread have reacted by trashing UHC, and trying to suggest this is a UHC-specific issue. It’s worth noting a couple of things: [ul] [li]A lot of the major carriers are losing money on the exchanges. In aggregate, the carriers lost [$2.5B](http://www.morningstar.com/news/dow-jones/TDJNDN_201511196451/unitedhealth-cuts-guidance-citing-affordable-care-act-2nd-update.html) in 2014. The main difference between UHC and the others appears to be that UHC is less tolerant of these short term losses, and perhaps less optimistic about future prospects.[/li][li]None of the professional industry analysts I’ve seen have taken this line. And perhaps more importantly, the stock market - reflecting the collective wisdom of people who have actual money on the line - doesn’t buy it either. Stocks in all major insurers tanked yesterday - [Aetna and Anthem more than UHC](http://news.investors.com/investing-stock-market-today/111915-781652-stocks-mixed-in-lower-volume.htm) - as did [stocks of hospitals](http://www.bloomberg.com/news/articles/2015-11-20/hospitals-feel-pain-as-unitedhealth-eyes-obamacare-exit-door) (who are thought to gain from increased of levels of private insurance).[/li][/ul] ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [November 20, 2015, 2:44pm UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/31 "2015-11-20T14:44:36Z")
I don’t think this should really be a surprise to anyone; it stands to reason that 10 million people buying health insurance for the first time in years (or ever) will have more health issues than others. By the same token, it stands to reason that exchange customers will gradually match the general insured population more and more over time. Unless other major players start pulling out, I don’t think this is news. > [@octopus](#): > > You think that a forced single payer would survive court scrutiny? Of course. It’s a valid exercise of Congress’ taxing power, just like Social Security. See Helvering v. Davis, for example. > [@Claverhouse](#): > > Just as an aside, how many times — rough average — is an American expected to change health insurance over a lifetime [let’s optimistically call that 80 years] ? Well, most of us get our health insurance through our employers, and employer’s don’t change plans that often. I’ve been with my employer for eight years and we’ve changed plan offerings once (in 2009 or so) and carriers once (in 2010 and 2015). Of course, the cost-sharing always differs slightly from year to year. ---
**Author:** ![JcWoman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jcwoman/32/2889_2.png) [@JcWoman](https://boards.straightdope.com/u/JcWoman)\ **Post date:** [November 20, 2015, 3:13pm UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/32 "2015-11-20T15:13:22Z")
> [@Really\_Not\_All\_That\_Bright](#): > > Well, most of us get our health insurance through our employers, and employer’s don’t change plans that often. I’ve been with my employer for eight years and we’ve changed plan offerings once (in 2009 or so) and carriers once (in 2010 and 2015). Of course, the cost-sharing always differs slightly from year to year. With a 30-year career I’m closer to the question than a young turk like you. 😉 I’ve changed employers about 8 times and a couple of them changed insurance on us a few times. So a rough guess for how many times I’ve changed insurance in 30 years is about 13 or 14 times. ---
**Author:** ![Trom](https://avatars.discourse-cdn.com/v4/letter/t/958977/32.png) [@Trom](https://boards.straightdope.com/u/Trom)\ **Post date:** [November 20, 2015, 3:35pm UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/33 "2015-11-20T15:35:53Z")
> [@DSeid](#): > > United is disingenuous. > > As provider we see the other majors working on developing systems that incentivize cost effective care, as the ACA was designed to incentivize; United not so much so. No question if you do not try you do not succeed. > > Then there is this play that they are making … [Harken Health](http://my.chicagotribune.com/#section/-1/article/p2p-84732493/). > > Harken is an “independent” subsidary of United that gives every appearence of being specifically designed to cherry pick young White not poor (very likely healthier) members. > > Yes, while United is making noise about getting out of the market that they never really entered or committed to, they have created a subsidary that allows them to cover only the lowest utilizers. > > The trick is to make a product that is attractive but accessible only to those who are unlikely to cost you much. Others had tried similar things with Medicare HMO products … having a product with attractive rates and networks with sign up in a building that required walking up two flights of stairs. (no cite for that, so leave it “as the story goes.”) Harken’s giimmick is that you can only access the otherwise overall attractive product using their staff model primary care providers who just happen to only be located in neighborhoods that are mostly populated with young White adults making significantly above a living wage. The article is wrong in that this is not an integrated model at all. It is brazen cherry picking. I had no idea about Harken. I’m exactly the person they’re looking for. Seeing as how my current plan is being canceled (two years in a row!), I’m in the market for something exactly like they describe. Awesome! ---
**Author:** ![Bone](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bone/32/407_2.png) [@Bone](https://boards.straightdope.com/u/Bone)\ **Post date:** [November 20, 2015, 4:12pm UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/34 "2015-11-20T16:12:58Z")
> [@Fotheringay-Phipps](#): > > That’s not as silly as may seem. The idea is that the sickest people would be the first to run out and buy insurance, but that if the market expanded to healthier people it would become more profitable. Of course - the example is mostly joking. But why would we expect healthy people to disproportionately go to the exchanges? Healthy people already have insurance. Healthy people who don’t have insurance have little incentive to get it. As an aside, thus far I’ve averaged switching insurance every 2.5 years. Either there is a better offering, or I switch jobs. I just switched again for 2016 since my company had to increase the cost of my previous plan significantly in response to the tax penalty they would have to pay since it was previously a “cadillac” plan. I am now paying more, and getting less. I’m switching to an HSA type plan and I think it’s a poor replacement. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [November 20, 2015, 4:15pm UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/35 "2015-11-20T16:15:07Z")
> [@Fotheringay-Phipps](#): > > A lot of ACA boosters in this thread have reacted by trashing UHC, and trying to suggest this is a UHC-specific issue. It’s worth noting a couple of things: > > [ul] > [li]A lot of the major carriers are losing money on the exchanges. In aggregate, the carriers lost [$2.5B](http://www.morningstar.com/news/dow-jones/TDJNDN_201511196451/unitedhealth-cuts-guidance-citing-affordable-care-act-2nd-update.html) in 2014. The main difference between UHC and the others appears to be that UHC is less tolerant of these short term losses, and perhaps less optimistic about future prospects.[/li][li]None of the professional industry analysts I’ve seen have taken this line. And perhaps more importantly, the stock market - reflecting the collective wisdom of people who have actual money on the line - doesn’t buy it either. Stocks in all major insurers tanked yesterday - [Aetna and Anthem more than UHC](http://news.investors.com/investing-stock-market-today/111915-781652-stocks-mixed-in-lower-volume.htm) - as did [stocks of hospitals](http://www.bloomberg.com/news/articles/2015-11-20/hospitals-feel-pain-as-unitedhealth-eyes-obamacare-exit-door) (who are thought to gain from increased of levels of private insurance).[/li][/ul] Meh. And their stock is already back up 3% today, half of yesterday’s loss. Over the year the stock had gone from a low of 95 and trading in the 50s before ACA (into 2013) to trading in the low 110s to 120s over the past half a year … yup, enthusiasm had it increasing by _120%_ plus. A one day correction for a disappointing report? Bupkiss. Aetna is back up 4% today so far, higher than it was a week ago, and _more than 300% higher_ than were it was in 2011. And Anthem’s correction began in May … and is also up today. And I won’t check every hospital stock but the first one I looked for, Tenet, is back up today, but has been in a decline since July. Why any investor would think hospitals are a good investment right now is beyond me. Census is down and the trajectory is crap for them. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [November 20, 2015, 4:24pm UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/36 "2015-11-20T16:24:20Z")
> [@Trom](#): > > I had no idea about Harken. I’m exactly the person they’re looking for. Seeing as how my current plan is being canceled (two years in a row!), I’m in the market for something exactly like they describe. Awesome! Yup. You are may be who they want to cherry pick. And if you live where they have placed their staff model primary care offices it is a pretty sweet deal that they can easily afford to offer if they get that prime demographic. From the young White consumer on the Exchange in those neighborhoods POV it is a decent plan. Can’t say what the quality of those staff model primary docs are … and they do directly work for the insurer … but in concept if they can score the healthy demographic by limiting access they can afford to pay for decent primary care office based care. Outside of that it is a traditional high deductible PPO with a reasonable selection of hospitals for a city dweller (better than Blue Choice’s for example). ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [November 20, 2015, 4:49pm UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/37 "2015-11-20T16:49:13Z")
> [@Bone](#): > > Of course - the example is mostly joking. But why would we expect healthy people to disproportionately go to the exchanges? We don’t need healthy people to disproportionately go to the exchanges. Healthy people vastly outnumber unhealthy people,\* so we only need them to sign up proportionately. Something like 80% of health spending goes towards 10% of patients. \*There are an awful lot of people out there with uncontrolled hypertension and/or hyperlipidemia, of course, but as long as those people aren’t seeking treatment they don’t cost insurers anything. ---
**Author:** ![Bone](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bone/32/407_2.png) [@Bone](https://boards.straightdope.com/u/Bone)\ **Post date:** [November 20, 2015, 5:00pm UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/38 "2015-11-20T17:00:35Z")
> [@Really\_Not\_All\_That\_Bright](#): > > We don’t need healthy people to disproportionately go to the exchanges. Healthy people vastly outnumber unhealthy people,\* so we only need them to sign up proportionately. Something like 80% of health spending goes towards 10% of patients. My previous post was ill-phrased. I was referring to the proportion of people that need to sign up going forward as compared to the group of people that have already signed up. In other words, for the viability to turn around, UnitedHealth is saying that the new signups need to be healthier than those who have already signed up. I’m not seeing how that is a reasonable expectation. ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [November 20, 2015, 5:03pm UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/39 "2015-11-20T17:03:11Z")
It’s not completely far-fetched. Individual Mandate penalties are going to be increasing going forward. ---
**Author:** ![Trinopus](https://avatars.discourse-cdn.com/v4/letter/t/2bfe46/32.png) [@Trinopus](https://boards.straightdope.com/u/Trinopus)\ **Post date:** [November 20, 2015, 8:53pm UTC](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013/40 "2015-11-20T20:53:34Z")
> [@adaher](#): > > . . . mandatory health insurance is unconstitutional . . . The Supreme Court said otherwise. What’s your cite? (The constitution permits military conscription, which is a whole hell of a lot more intrusive than a tax to pay for health care.) [Previous page](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013.md?page=1) [Next page](https://boards.straightdope.com/t/unitedhealth-warns-it-may-exit-obamacare-plans/738013.md?page=3)